Attention Deficit Hyperactivity Disorder
(ADHD)(ADD)
Medical Author: Dennis S. Phillips, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
What is attention deficit hyperactivity disorder (ADHD)?
ADHD refers to a pattern of ongoing, long-standing ("chronic") behavior disorders that have three core symptoms: hyperactivity, impulsivity, and inattention.
These are defined as "disorders" based on the child's stage of development. No one expects much quiet activity, impulse control, or attention span from the average, normal
2-year-old. But by age 5 or 6, it is expected that the child is beginning to regulate his activity level, control his behavior, and attend to tasks. The ADHD child has not achieved these capacities. And the degree to which each of these symptoms show themselves can vary greatly from child to child. The problems that these disorders create show up in all areas of the child's life from home to school to social settings. It is no surprise, then, that ADHD has been shown to have long-term adverse effects on social-emotional development, school performance, and vocational success. Children with ADHD experience an inability to sit still and pay attention in class and the negative consequences of such behavior. They experience peer rejection and engage in a broad array of disruptive behaviors. Their academic and social difficulties have far-reaching and adverse long-term consequences. These children have higher injury rates. As they grow older, children with unrecognized/untreated ADHD are more prone to experience drug abuse, gang activity, other antisocial activities, and other conduct disorders. The symptoms of significant ADHD persist into adolescent years and very often into adulthood.
What are the symptoms of ADHD?
The diagnostic criteria for ADHD are outlined in the Diagnostic and Statistical Manual of Mental Health, 4th ed. (DSM-IV), Copyright 1994, American Psychiatric Association. All of the symptoms of inattention, hyperactivity, and impulsivity must have persisted for at least
six months to a degree that is maladaptive and inconsistent with the developmental level of the child.
Inattention:
- Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
- Often has difficulty sustaining attention in tasks or play activities
- Often does not seem to listen when spoken to directly
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
- Often has difficulty organizing tasks and activities
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
- Often loses things necessary for tasks or activities (for example, toys, school assignments, pencils, books, or tools)
- Is often easily distracted by extraneous stimuli
- Is often forgetful in daily activities
Hyperactivity:
- Often fidgets with hands or feet or squirms in seat
- Often leaves seat in classroom or in other situations in which remaining seated is expected
- Often runs about or climbs excessively in situations in which it is inappropriate
- Often has difficulty playing or engaging in leisure activities quietly
- Often talks excessively
Impulsivity:
- Often blurts out answers before questions have been completed
- Often has difficulty awaiting turn
- Often interrupts or intrudes on others (for example, butts into conversations or games)
In addition, some hyperactive, impulsive or inattention symptoms that cause present difficulties were present before 7 years of age, and are present in
two or more settings (at school [or work] or at home). There must be clear evidence of significant impairment in social, academic, or occupational functioning. And the symptoms are not entirely caused by another severe physical disorder (for
example, severe illness associated with chronic pain) or mental disorder (for
example, schizophrenia, other psychotic disorders, severe disabling mood disorders, etc.).
Next: How is ADHD diagnosed? »
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